Stem cell transplantation and hematopoietic growth factors

Hematopoietic growth factors are commonly used in allogeneic and autologous stem cell transplantation. The growth factors most frequently used are human recombinant erythropoietin, filgrastim, and sargramostim, and a number of trials have been done using them either singly or in various combinations for mobilization, post-transplant, and for delayed engraftment. Filgrastim and sargramostim can shorten the neutropenic period and decrease infectious complications post-transplant, thus lowering the cost of both autologous and allogeneic transplants. Erythropoietin has not been particularly effective for mobilization, and studies have not shown its efficacy in reducing red blood cell transfusions in autologous transplants. However, they have been clinically beneficial in allogeneic transplantation and in delayed erythropoiesis post-transplantation. Stem cell factor remains investigational at this time but seems promising. The new long-acting erythropoietin and filgrastim are also introduced here and briefly discussed.